Wang Yifei, Yue Zhenhua, Shi Xiaoqian, Xia Guozhan, Qin Linlin, Sun Qi, Huang Yiling, Chen Rong, Zhao Xuewei, Wang Mingdong
Department of Thoracic Surgery, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Pulmonary and Critical Care Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Front Med (Lausanne). 2025 Jan 13;11:1506254. doi: 10.3389/fmed.2024.1506254. eCollection 2024.
Accurate preoperative positioning is the key to the success of thoracoscopic surgery for small pulmonary nodules. There are many methods for locating pulmonary nodules in clinical practice, but there are currently few research reports on the value of medical adhesive localization.
To compare the clinical value of two positioning methods, medical adhesive and metal spring coil, in the preoperative application of VATS through retrospective analysis.
A total of 288 patients who underwent thoracoscopic surgery in our hospital from January 2021 to June 2024 due to the discovery of solitary pulmonary nodules during chest CT examination were included in this study. Preoperative patients were randomly divided into two groups, with 205 patients undergoing preoperative medical adhesive positioning (Group A) and 83 patients undergoing metal spring coil positioning (Group B). After the positioning was completed, record the positioning time of each group of patients and the immediate pain score 15 min after the positioning was completed, the complications located in each group of patients, and whether there was positioning failure or not.
The localization success rate of the medicine adhesive positioning group [99.5% (204/205)] was higher than that of the metal spring coil positioning group [91.6% (76/83)] ( = 0.001). The positioning time of the medical adhesive positioning group was 12.00 (10.00, 14.00) min, which was shorter than the 13.00 (11.00, 16.00) min of the micro coil group ( = 0.001). The immediate pain score (2.32 ± 0.79) of the medical adhesive positioning group 15 min after positioning was significantly lower than that of the metal spring coil positioning group (3.97 ± 0.54) ( < 0.001). The incidence of complications such as pneumothorax [15.7% (13/83) vs 5.4% (11/205), = 0.004], pulmonary hemorrhage/hemoptysis [20.5% (17/83) vs 4.9 (10/205), < 0.001] was significantly higher in the metal coil positioning group than in the medical adhesive positioning group.
Preoperative medical adhesive positioning for pulmonary nodules is safe, reliable, and effective. Compared with metal spring coil positioning, it has shorter positioning time, milder pain after positioning, lower incidence of positioning related complications, and more flexible arrangement of surgical timing after positioning. It has high clinical application value.
准确的术前定位是小肺结节胸腔镜手术成功的关键。临床实践中肺结节定位方法众多,但目前关于医用黏合剂定位价值的研究报道较少。
通过回顾性分析比较医用黏合剂和金属弹簧圈两种定位方法在胸腔镜手术术前应用中的临床价值。
选取2021年1月至2024年6月在我院因胸部CT检查发现孤立性肺结节而接受胸腔镜手术的288例患者纳入本研究。术前将患者随机分为两组,205例患者接受术前医用黏合剂定位(A组),83例患者接受金属弹簧圈定位(B组)。定位完成后,记录每组患者的定位时间、定位完成后15分钟的即刻疼痛评分、每组患者发生的并发症以及是否存在定位失败情况。
医用黏合剂定位组的定位成功率[99.5%(204/205)]高于金属弹簧圈定位组[91.6%(76/83)](P = 0.001)。医用黏合剂定位组的定位时间为12.00(10.00,14.00)分钟,短于微线圈组的13.00(11.00,16.00)分钟(P = 0.001)。医用黏合剂定位组定位后15分钟的即刻疼痛评分(2.32±0.79)显著低于金属弹簧圈定位组(3.97±0.54)(P < 0.001)。金属线圈定位组气胸[15.7%(13/83)比5.4%(11/205),P = 0.004]、肺出血/咯血[20.5%(17/83)比4.9%(10/205),P < 0.001]等并发症的发生率显著高于医用黏合剂定位组。
肺结节术前医用黏合剂定位安全、可靠、有效。与金属弹簧圈定位相比,其定位时间短、定位后疼痛轻、定位相关并发症发生率低,且定位后手术时机安排更灵活。具有较高的临床应用价值。